Prognostic value of arrhythmogenic markers in systemic hypertension.
OBJECTIVE
To evaluate the prognostic value of arrhythmogenic markers in hypertensive patients.


METHODS
Two hundred and fourteen hypertensive patients without symptomatic coronary disease, systolic dysfunction, electrolyte disturbances or anti-arrhythmic therapy were included. Recordings were made of 12-lead standard ECGs with calculations of QT interval dispersion, 24 h Holter ECGs (204 patients), echocardiography (187 patients) and signal-averaged ECGs (125 patients).


RESULTS



METHODS
echocardiographic left ventricular hypertrophy was found in 63 patients (33.7%), non-sustained ventricular tachycardia (Lown class IV b) in 33 patients (16.2%), ventricular late potentials in 27 patients (21.6%). Mortality: after a mean follow-up of 42.4 +/- 26.8 months, global mortality was 11.2% (24 patients), cardiac mortality 7.9% (17 patients), sudden death 4.2% (nine patients). Univariate analysis: predictors of global, cardiac and sudden death were age > or = 65 years, ECG strain pattern, Lown class IV b and QT interval dispersion > 80 ms (P < or = 0.01). Left ventricular mass index was closely related to cardiac mortality (P = 0.002). Multivariate analysis: only Lown class IV b was an independent predictor of global (RR 2.6, 95% CI 1.2-6.0) and cardiac mortality (RR 3.5, 95% CI 1.2-9.7).


CONCLUSIONS
In hypertensive patients, non-sustained ventricular tachycardia has a prognostic value.
Galinier
M
M
Cardiology Department, Rangueil University Hospital, Toulouse, France.
Balanescu
S
S
Fourcade
J
J
Dorobantu
M
M
Albenque
J P
JP
Massabuau
P
P
Doazan
J P
JP
Fauvel
J M
JM
Bounhoure
J P
JP
D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*